Due to its short half-life, and rapid absorption, alprazolam is distinguished as one of the most rapid-acting BZD with fastest relief of symptomology, increasing its abuse liability [54]. Alprazolam is widely used as monotherapy for panic disorder and anxiety and was found superior to other forms of monotherapy for these conditions including other BZD, non-SSRI antidepressants, and buspirone. This superior effect is thought to be due to its unique alpha-2 adrenergic activity, enhancing its potency for relieving panic and anxiety disorders. This same mechanism is also thought to be the cause behind alprazolam’s strong rebound hyperadrenergic effects with cessation [54,55]. Many drug therapies have been suggested as treatment for alprazolam withdrawal with few rendered effective.

• Support groups and peer support can be lifelines in the choppy seas of recovery.
• Improvement from the withdrawal syndromes usually occur gradually, sometimes as people taper, or slowly over the months and years after their benzodiazepine cessation.
• Below is a summary of points to consider when drawing up your own schedule.
• Opioid withdrawal can be managed with anti-nausea medications and antidiarrheals, while benzodiazepine withdrawal is more likely to require pausing the taper and/or switching to a different type of benzodiazepine or sedative.
• According to the classification, these drugs have a low potential for abuse and low risk of dependence.

What happens when you stop taking benzodiazepines?

Patients in benzodiazepine withdrawal should be monitored regularly for symptoms and complications. Patients should be monitored regularly (3-4 times daily) for symptoms and complications. The Short Opioid Withdrawal Scale (SOWS, p.37) is a useful tool for monitoring withdrawal. During withdrawal some patients may become disruptive and difficult to manage. The patient may be scared of being in the closed setting, or may not understand why they are in the closed setting. In the first instance, use behaviour management strategies to address difficult behaviour (Table 2).

Breaking Addiction: Timeline, Factors, and Strategies for Recovery

It is important to note that these symptom lists are not meant to diagnose or take the place of medical advice. Contact your doctor as soon as you have concerns about benzo dependence. If you benzodiazepine withdrawal have been taking benzos for more than 4 weeks, contact your doctor for advice on how to safely taper your dosage. Patients should drink 2-3 litres of water per day while in withdrawal.

Withdrawal Syndromes

The risk of falls leading to injuries in elderly BZD users is significantly increased in patients greater than 80 years old, while the increased risk is not significant in patients under 80 [22]. Passaro et al. described an increased risk of falls in elderly hospitalized patients prescribed short-acting BZD [23]. For mothers with BZD use during pregnancy, there is a risk of premature birth and low birth weight.

How severe are the symptoms of withdrawal?

Other studies have shown that there is no correlation between BZD use and cognitive decline. One study showed that administration of BZD in patients with Alzheimer’s disease do not lead to further cognitive decline after 18 months of taking the drug [74]. The subjects in this study had mild to moderate Alzheimer’s https://ecosoberhouse.com/ dementia and showed no change in AD-Cog scores after treatment with BZD [74]. Interestingly, in this same study, SSRIs and atypical antipsychotics showed the same results; however, trazodone actually improved the NPI [75]. One of the most well-studied BZDs in the setting of withdrawal is alprazolam.

A patient-centered approach is key to tapering opioids and benzodiazepines. Clinician and patient should share in the process of deciding whether to taper off completely or reduce the dose to a safer level, as well as the speed of the taper. Should withdrawal or severe pain or anxiety occur, patients should have the option to slow down or even pause the taper.

• Interestingly, in this same study, SSRIs and atypical antipsychotics showed the same results; however, trazodone actually improved the NPI [75].
• More studies need to be performed on treating withdrawal with propranolol, including testing it as a potential adjunct to tapering off both long-acting and short-acting BZD.
• This is more significant than the study by Weich et al. [47] which found a 2-fold increased hazard of death in 7 years.
• Older people can withdraw from benzodiazepines as successfully as younger people, even if they have taken the drugs for years.
• The importance of professional supervision during withdrawal cannot be overstated.

Tapering changes